Risk of cervical cancer in inflammatory bowel disease: A meta-analysis of population-based studies

Mann, Simran; Jess, Tine; Allin, Kristine H.; Elmahdi, Rahma

doi:10.14309/ctg.0000000000000513

Cited by 6 publications

(4 citation statements)

References 32 publications

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“…This risk is influenced by the patient's specific risk factors, such as older age and smoking, and by the concomitant use of TNFi. However, the overall incidence remains low and recent guidelines conclude that patients treated with thiopurines should adhere to the skin and cervical cancer screening programs recommended for the general population [10,28,70,100,[106][107][108][109]121,125,127].…”

Section: Discussionmentioning

confidence: 99%

“…There is conflicting data on the risk of cervical neoplasia in women with IBD, particularly those undergoing thiopurines [28,47,70,[124][125][126]. In a recent meta-analysis of five unselected population-based studies including 74,310 patients with IBD and 2,029,087 reference patients, the authors did not show a statistically significant increased risk for cervical cancer in IBD patients under therapy with thiopurines (HR = 0.96; 95% CI, 0.60-1.50) [127]. However, a meta-analysis published in 2015 that took into account five retrospective cohort studies and three case controls studies of patients with IBD on any immunosuppression, including steroids, thiopurines, or biologic therapy, with cervical high-grade dysplasia/cancer, revealed an increased risk of cervical high-grade dysplasia (HGD) or cancer in patients with IBD on any immunosuppressive therapy and compared with population controls without IBD (OR: 1.34; 95% CI: 1.23-1.46] [125].…”

Section: Thiopurinesmentioning

confidence: 99%

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Extraintestinal Cancers in Inflammatory Bowel Disease: A Literature Review

Massano

Bertin

Zingone

et al. 2023

Cancers

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Background: Inflammatory bowel disease (IBD) is a group of chronic multifactorial inflammatory disorders including two major entities: Crohn’s disease (CD) and ulcerative colitis (UC). Preliminary evidence suggests that patients with IBD may be at increased risk of developing intestinal and extraintestinal cancers (EICs). Actually, little is known about the association between IBD and EICs, and there is ever-growing concern regarding the safety of immunomodulators and biological therapy, which may represent a risk factor for carcinogenesis. Aims: The aim of this review is to summarize the evidence regarding the association between IBD and EICs, the safety of immunomodulators and biological therapy and the management of immunomodulators and biologic agents in IBD patients with prior or current EICs. Results: IBD patients have a higher risk of developing different forms of extraintestinal solid organ tumors and hematological malignancies. Immunomodulators and biological therapy may increase the risk of developing some types of EICs and may be consciously used in patients with IBD and current or prior history of malignancy. Conclusions: Decisions regarding the use of immunomodulators or biological therapies should be made on an individual basis, considering a multidisciplinary approach involving oncologists.

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Section: Discussionmentioning

confidence: 99%

Section: Thiopurinesmentioning

confidence: 99%

Extraintestinal Cancers in Inflammatory Bowel Disease: A Literature Review

Massano

Bertin

Zingone

et al. 2023

Cancers

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“…The pathogenesis of UC is unknown and is related to a variety of factors including genetics, immunity, gut ora and environmental factorsz (El Mouzan et al 2013; Deng et al 2023;Zhou et al 2023). With the deepening of the research, it is found that the intestinal ora has a closer connection with UC, and the bene cial bacteria in the intestinal ora such as Faecalibacterium Prausnitzii, Roseburia and bacteroides can secrete short-chain fatty acids and secondary bile acids to regulate the immune system and the proliferation and development of intestinal epithelial cells to keep the intestinal mucosa intact (Mann et al 2022; Chen et al 2023), and regulate the neurotransmitters and vasoreactivity as well as energy metabolism at the same time, and further alleviate the intestinal in ammation to achieve the goal of protect the intestinal mucosa. However, when the gut ora is out of balance, it can lead to the accumulation of harmful substances, damage the intestinal mucosa, enhance the invasiveness of pathogens and exacerbate symptoms in UC patients.…”

Section: Introductionmentioning

confidence: 99%

Intestinal flora and ulcerative colitis: A Mendelian Randomization study

Qu,

Cheng,

Wang

et al. 2024

Preprint

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A large body of clinical data and observational studies suggest that intestinal flora is associated with ulcerative colitis (UC). However, the causal relationship between gut flora and UC remains to be determined. To investigate the potential causal relationship between intestinal flora and UC, a two-sample Mendelian randomization (MR) analysis was performed in this study. We obtained genome-wide association data for gut flora and UC from published GWAS databases and performed dual sample MR analysis using inverse variance weighting (IVW) to identify potential UC beneficial or deleterious gut flora. Sensitivity analysis, including multi potency and heterogeneity assays, was performed to validate the stability of MR primary assays. In this study, we found a negative correlation between three genera of bacteria and the risk of UC developing into beneficial floras. They include Genus Butyrivibrio [OR = 0.908, 95%CI (0.835, 0.987), P = 0.0229]; Genus Clostridiuminnocuumgroup [OR = 0.847, 95%CI (0.752, 0.955), P = 0.00646]; and Genus Lactococcus [OR = 0.886, 95%CI (0.796, 0.986), P = 0.0263]. The analysis of pleiotropy showed that the MR-Egger regression intercept P > 0.05 for all three, and the Q-pval > 0.05 for the heterogeneity analysis, indicating that there was no pleiotropy or heterogeneity in the above-mentioned bacterial groups. This study expands the intestinal flora associated with UC risk and provides a theoretical basis for further relevant experiments and clinical studies.

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“…These results are in contrast to the most recent meta‐analysis. Mann et al identified 5 population‐based studies, including 74,310 patients with IBD and 2,029,087 reference patients, across 5 different countries 3 . A meta‐analysis by disease subtype indicated no statistically significant increased risk in Crohn's disease (HR: 1.36; 95% CI: 0.83–2.23) or ulcerative colitis (HR: 0.95; 95% CI: 0.72–1.25) or in patients treated with thiopurines (HR: 0.96; 95% CI: 0.60–1.50).…”

mentioning

confidence: 99%